Clinical question
How effective are intra-articular corticosteroids (IACs) in people with knee osteoarthritis (OA)?
Bottom line
Compared with sham or no intervention, IACs may result in a moderate improvement in pain and a small improvement in physical function measured at 1–6 weeks. The effects decreased over time, and there was no evidence an effect remained after 6 months. Those receiving IACs as treatment had a similar number of side effects as those receiving placebo, but the information was neither precise nor reliable.
Caveat
Most of the studies were small and hampered by low methodological quality. A single trial described adequate measures to minimise biases, and did not find any benefit from IACs.
Context
Knee OA is a leading cause of chronic pain, disability and decreased quality of life. Despite the long-standing use of IACs, there is ongoing debate about their benefits and safety.
Cochrane Systematic Review
Juni P et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Reviews, 2015, Issue 10. Art. No.: CD005328.DOI: 10.1002/14651858. CD005238.pub3. This review contains 27 studies involving 1767 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
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